Patient safety

Cancer Drugs Fund delivered ‘no meaningful value’ to patients

The Cancer Drugs Fund (CDF) set up by David Cameron to pay for medicine for over 100,000 people was not good value for money, despite costing the NHS around £1.3bn to develop, according to a new report.  

Established in 2010, the CDF was set up as a way of helping cancer patients pay for expensive medicine, but was transferred into the remit of NICE in March 2016 due to it being financially unstable.

However, research undertaken by professors at King’s College London and published in journal the Annals of Oncology found that only 18 out of the 47 drugs (38%) in the CDF provided patients with significant overall survival benefit.

On top of that, only 9 actually met European Society for Medical Oncology (ESMO) criteria for safety and effectiveness to patients, and 23 matched the American Society of Clinical Oncology criteria.

The research concluded that the CDF did not deliver “meaningful value to patients or society,” despite costing the NHS valuable funds to set up and implement.

A lead researcher of the project, professor Richard Sullivan said: “A ring-fenced drugs fund was created despite a lack of evidence that prioritising drug expenditure would improve outcomes for cancer patients over and above greater investment in the whole cancer management pathway, which includes screening, diagnostics, radiotherapy, surgery and palliative care.”

Prof Sullivan also added that the findings underlined the importance of reimbursement decisions for all drugs, and procedures and interventions in cancer care being made through appropriate health technology appraisal processes.

“Only in this way will decisions be made on the best available evidence so as to maximise the value for cancer patients and society as a whole,” he explained.

The professor also said it was a shame that the NHS had also lost a major opportunity to understand how the medicines work in the real world, as the research also found that no data on the outcome of patients was collected during the course of the Fund.

Cancer Research UK agreed with the findings, as Emlyn Samuel, senior policy manager at the charity, said the Fund “wasn’t fit for purpose”.

“Collecting data on drugs in the new CDF, we hope it will help give patients better access to innovative cancer drugs. Cancer Research UK will continue to monitor the impact of the new CDF,” Samuel commented.

However, Baroness Delyth Morgan, chief executive at charity Breast Cancer Now, said that the Fund had actually delivered “a totally transformational impact” on the lives of breast cancer patients.

“This analysis actually makes clear that breast cancer drugs Perjeta and Kadcyla – which were not approved by NICE but which the CDF made available – provide a substantial improvement upon the current NICE-approved standard of care,” she argued.

However, Baroness Morgan did admit that the missed opportunity to collect real-world evidence on the drugs in the Fund was “inexcusable”.

“The Fund was only ever intended as a sticking plaster to enable patients to access effective modern cancer drugs while the significant flaws in the NICE appraisal process were fixed,” she said. “But, unfortunately, no effective reform has been forthcoming.”

And Meg Hillier, chair of the Public Accounts Committee, claimed that the research backed up what the committee had said about the Fund when it reviewed it at the start of 2016.

“If patients seeking support through schemes such as this are to get the best possible treatment, there must be confidence that public money is being spent on the right medication, at a fair price,” she said.

“As this new study further makes clear, the Fund did not represent meaningful value.

“This must serve as a lesson to future governments seeking to commit public money to projects that, without effective management, are doomed to fail both patients and taxpayers in general.”

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